Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003957887 |
---|---|
Provider Name | Gary T. Majourau |
First Address | San Francisco, CA 94121-2422 |
Second Address | San Francisco, CA 94103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2007 |
Last Update Date | 04/09/2008 |